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(Pediatrics in Review. 2007;28:69-72.)
© 2007 American Academy of Pediatrics

Complementary, Holistic, and Integrative Medicine: St. John’s Wort


Theresa L. Charrois, BScPharm, MSc*
Candace Sadler*
Sunita Vohra, MD, MSc*
 * Complementary and Alternative Research and Education (CARE) Program, Department of Pediatrics, University of Alberta, Canada, on behalf of the American Academy of Pediatrics Provisional Section on Complementary, Holistic, and Integrative Medicine

The first 300 words of the full text of this article appear below.


   Introduction
 
St. John’s wort, derived from the Hypericaceae family, has played a medicinal role for thousands of years. (1) Although it has been used empirically for a wide range of ailments in the past, including skin conditions, nerve problems, and muscle pain, the primary uses currently are for depression and nervous conditions, (2)(3)(4)(5)(6)(7) due to its ability to inhibit the reuptake of dopamine, serotonin, and norepinephrine within the brain. (2)

Although promising evidence is emerging for the clinical use of St. John’s wort, data specific to pediatrics are still limited, warranting additional research.


   Evidence of Efficacy in Pediatrics
 
Surveys in the United States and Britain of herbal use for the treatment of pediatric depression (8)(9) demonstrate that St. John’s wort is used commonly by children (22% and 9% in the two surveys, respectively). Formal evaluation of efficacy in pediatric populations is preliminary but shows some promise. Presently, no systematic reviews or randomized, controlled trials have been published regarding the use of St. John’s wort in children.

An open-label pilot study conducted by Findling and associates (10) analyzed the use of St. John’s wort in children between the ages of 6 and 16 years for treatment of major depressive disorder. The starting dose was 150 mg 3 times daily for 4 weeks. Exclusion criteria included failure to respond to 4 weeks of antidepressant therapy. Patients considered clinically nonresponsive to St. John’s wort (as per a priori criteria) after 4 weeks had their dosage increased to 300 mg 3 times daily. A total of 33 patients were enrolled in the study, with a mean age of 10.5 years (SD, 2.9 y). At the end of the 8-week trial, 25 patients met the criteria of clinical response . . . [Full Text of this Article]






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